Provider Demographics
NPI:1043566789
Name:BROWN, ALBERT WEST (RN)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:WEST
Last Name:BROWN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1679 E 29TH ST
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-1705
Mailing Address - Country:US
Mailing Address - Phone:216-310-4022
Mailing Address - Fax:
Practice Address - Street 1:1679 E 29TH ST
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-1705
Practice Address - Country:US
Practice Address - Phone:216-310-4022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH378998163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse